Pedicle screw and operating device thereof

ABSTRACT

Disclosed is a spine fixation apparatus, more particularly, a pedicle screw implanted into a spine and an operating device for the pedicle screw capable of easily inserting a rod to a head section of the pedicle screw in order to securely fix the spine. The pedicle screw has a head section including a recess part defined by first and second sidewalls, a screw section, and a support unit formed at an upper portion of the recess part of the head section while connecting the first sidewall to the second sidewall. The operating device has a screw coupling rod having an elongated pipe shape, a body having a first side coupled to the screw coupling rod, a rotating member having a first end coupled to a second side of the body in such a manner that a second end of the rotating member rotates about the first end thereof, and a rod receiver coupled to the second end of the rotating member. Due to the support unit, the rod is prevented from being easily separated from the pedicle screw, thereby facilitating minimum incision surgery. The operating device for the pedicle screw allows an operator to easily perform minimum incision surgery while making several incisions for the pedicle screws and the rod in the back of the patient and keeping the size of incisions quite a small.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a spine fixation apparatus, and moreparticularly to a pedicle screw implanted into a spine and an operatingdevice for the pedicle screw capable of easily inserting a rod to a headsection of the pedicle screw in order to securely fix the spine.

2. Description of the Prior Art

As generally known in the art, a spine fixation apparatus is providedfor treating patients who have vertebral disease caused by trafficaccidents or fall accidents. For instance, the spine fixation apparatusconnects bones forming the spine to each other so as to assist patientswith vertebral fracture to be restored to health.

A patient makes a living with a spine fixation apparatus implanted intothe spine of the patient. Thus, a subsidiary implanted into a body ofthe patient must have a simple structure and must not be deformed orreleased even if the patient takes an active life for a long period oftime.

FIG. 1 shows a conventional spine fixation apparatus. Referring to FIG.1, the conventional spine fixation apparatus includes a pedicle screw100 provided with a rod 104 and a coupling screw 102 which are coupledto an upper portion of the pedicle screw 100.

The pedicle screw 100 is provided at an upper end thereof with a headsection 110 and a lower end thereof with a screw section 120. The rod104 is inserted into a recess 114 of the head section 110. The recess114 is defined by first and second sidewalls 111 and 112 and receivesthe rod 104 therein.

When the rod 104 has been received in the head section 110 of thepedicle screw 100, the coupling screw 102 is screw-coupled into theupper portion of the pedicle screw 100 so as to prevent the rod 104 frombeing separated from the pedicle screw 100. The first and secondsidewalls 111 and 112 of the head section 110 are formed at innerportions thereof with screw sections such that the coupling screw 102 issecurely fixed to the head section 110 of the pedicle screw 100.

The screw section 120 of the pedicle screw 100 is screw-coupled into abone of a spine of a patient so that the pedicle screw 100 is implantedinto a body of the patient. The pedicle screw 100 is connected to theother pedicle screw, which is screw-coupled with the other bone of thespine of the patient, through the rod 104.

The rod 104 is inserted into the pedicle screw 100 from an upper portionof the pedicle screw 100 when the pedicle screw 100 is implanted intothe patient. Accordingly, it is necessary to make elongated incisions inthe patient's back. That is, the back of the patient must be incisedcorresponding to a length of the rod 104. Reference numeral 116represents an inner bottom surface of the head section 110.

The current tendency of a surgical operation is to minimize an incisionpart in a human body. Thus, there has been suggested a method capable ofminimizing an incision part in the back of a patient when a pediclescrew is implanted into the body of the patient. According to the abovemethod, a rod is inserted into the pedicle screw from a lateral portionof the pedicle screw instead of inserting the rod from an upper portionof the pedicle screw. In this case, two pedicle screws can be implantedinto the body of the patient without incising the back of the patient ina long size by forming only three incisions (two is for pedicle screwsand one is for the rod) in the back of the patient.

When the rod is inserted into the pedicle screw from the lateral portionof the pedicle screw, one end of the rod must be easily inserted into arecess part of the pedicle screw. In addition, it is necessary toprevent the rod from being easily separated from the recess part. Therod is inserted into the recess part of a head section of the pediclescrew and fixedly coupled thereto by means of a coupling screw.Accordingly, the rod can be easily separated from the head section ofthe pedicle screw before the coupling screw is coupled thereto.

For this reason, if the conventional pedicle screw is used for theminimum incision surgery, the pedicle screw may be separated from thepedicle screw while the surgery operation is being carried out,resulting a delay or a failure of the surgery operation.

In addition, since the minimum incision surgery is carried out whilemaking several incisions in the back of the patient while keeping thesize of the incisions quite small, a position of the pedicle screw isnot exposed to an exterior. Thus, it is difficult to determine acoupling position of a screw section of the pedicle screw having adiameter of about 5 mm with respect to the spine of the patient.

In the meantime, the minimum incision surgery requires great skill whendetermining the coupling position of the pedicle screw with regard tothe spine of the patient and inserting the rod into the pedicle screwfrom the lateral portion of the pedicle screw. This is because theincisions made in the back of the patient tend to be clogged by skin andthe operator cannot see the pedicle screw, which has already beenimplanted in the body of the patient. Thus, the operator must performthe surgical operation while gripping the pedicle screw with one hand inorder to couple the pedicle screw to a precise position of the spine ofthe patient.

That is, since the minimum incision surgery is carried out while makingseveral incisions in the back of the patient and keeping the size of theincisions quite small, the location of the pedicle screw is“subcutaneous”, so that the operator cannot easily carry out minimumincision surgery.

Therefore, it is necessary to provide an apparatus to facilitate minimumincision surgery capable of allowing the operator to easily couple apedicle screw to the spine of the patient and insert a rod into thepedicle screw from a lateral portion of the pedicle screw.

SUMMARY OF THE INVENTION

Accordingly, the present invention has been made to solve theabove-mentioned problems occurring in the prior art, and an object ofthe present invention is to provide a pedicle screw including a supportunit, which connects a first sidewall of a head section to a secondsidewall of the head section in order to prevent a rod, which isinserted into the head section of the pedicle screw from a lateralportion of the pedicle screw, from being separated upward from the headsection.

Another object of the present invention is to provide a pedicle screwincluding an indicator protruding from an end of a screw section of thepedicle screw for precisely indicating an insertion point of the pediclescrew during minimum incision surgery.

Still another object of the present invention is to provide an operatingdevice for a pedicle screw allowing an operator to easily performminimum incision surgery while making several incisions for the pediclescrew and a rod in the back of a patient.

To accomplish the above objects, according to one aspect of the presentinvention, there is provided a pedicle screw comprising: a head sectionincluding a recess part defined by first and second sidewalls; a screwsection; and a support unit formed at an upper portion of the recesspart of the head section while connecting the first sidewall to thesecond sidewall.

According to the preferred embodiment of the present invention, thepedicle screw has a guide hole extending from an inner bottom surface ofthe head section to a lower end portion of the screw section.

To accomplish the above objects, according to another aspect of thepresent invention, there is provided an operating device for a pediclescrew, the operating device comprising: a screw coupling rod having anelongated pipe shape; a body having a first side coupled to the screwcoupling rod; a rotating member having a first end coupled to a secondside of the body in such a manner that a second end of the rotatingmember rotates about the first end thereof, and a rod receiver coupledto the second end of the rotating member.

According to the preferred embodiment of the present invention, the bodyincludes a coupling hole into which the first end of the rotating memberis inserted and an elongated rod having a coupling slot for coupling thescrew coupling rod.

The screw coupling rod is coupled to the body by means of a couplingmember, the elongated rod extends by passing through the couplingmember, and the coupling member is provided with a first screw, which isscrew-coupled with the coupling slot, and a second screw for supportingthe screw coupling rod.

The rod receiver has a curved shape in the form of an arc and the rod isdetachably coupled to one end of the rod receiver. The rod receiver isprovided at an inner portion thereof with a flexible shaft, which isscrew-coupled with one end of the rod, and the rod is coupled with orseparated from the rod receiver according to a rotational direction ofthe flexible shaft

The screw coupling rod has an upper end portion coupled to the body anda lower end portion into which a pedicle screw is inserted. The screwcoupling rod is formed at a lower end portion thereof with a rod hole.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other objects, features and advantages of the presentinvention will be more apparent from the following detailed descriptiontaken in conjunction with the accompanying drawings, in which:

FIG. 1 is a perspective view showing a conventional spine fixationapparatus;

FIG. 2 is a front view of a pedicle screw according to one embodiment ofthe present invention;

FIG. 3 is a plan view of a pedicle screw according to one embodiment ofthe present invention;

FIG. 4 is a perspective view of a pedicle screw according to oneembodiment of the present invention;

FIG. 5 is a perspective view showing usage of a pedicle screw accordingto one embodiment of the present invention;

FIG. 6 is a perspective view showing usage of a pedicle screw accordingto one embodiment of the present invention;

FIG. 7 is a perspective view showing an operating device for a pediclescrew according to one embodiment of the present invention;

FIG. 8 is a front view showing an operating device for a pedicle screwaccording to one embodiment of the present invention;

FIG. 9 is a plan view showing an operating device for a pedicle screwaccording to one embodiment of the present invention;

FIG. 10 is a perspective view showing an operational state of anoperating device for a pedicle screw according to one embodiment of thepresent invention;

FIG. 11 is an enlarged sectional view showing a rod inserted into a rodreceiver according to one embodiment of the present invention; and

FIG. 12 is an enlarged sectional view showing a rod being separated froma rod receiver according to one embodiment of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Hereinafter, a preferred embodiment of the present invention will bedescribed with reference to the accompanying drawings.

FIGS. 2 to 4 are front, plan and perspective views of a pedicle screwaccording to one embodiment of the present invention Referring to FIGS.2 to 4, the pedicle screw includes a head section 10 formed with firstand second sidewalls 11 and 12. A recess 14 is formed between the firstand second sidewalls 11 and 12 and a support unit 18 is formed at anupper portion of the recess 14 in order to connect the first sidewall 11to the second sidewall 12.

The support unit 18 horizontally connects upper portions of the firstand second sidewalls 11 and 12 to each other. Thus, the support unit 18forms a hole having a predetermined size together with the recess 14.The shape and position of the support unit 18 may vary so far as thesupport unit 18 connects the first sidewall 11 to the second sidewall 12and prevents a rod (not shown) from being separated upwardly of therecess 14. As shown in FIG. 3, the recess 14 is formed with a screw hole17 such that a coupling screw (102, see FIG. 6) can be screw-coupledwith the recess 14 from an upper portion of the support unit 18. Sincethe coupling screw 102 is screw-coupled with the screw hole 17 of therecess 14, the support unit 18 must be aligned such that it does notblock a movement path of the coupling screw 102.

A guide hole 19 is formed at a center of an inner bottom surface 17 ofthe head section 10 formed between the first and second sidewalls 11 and12 of the head section 10. The guide hole 19 downwardly extends from theinner bottom surface 17 of the head section 10 to a lower end of a screwsection 20 through an inner portion of the screw section 20.

FIG. 5 is a perspective view showing usage of a pedicle screw accordingto one embodiment of the present invention. Referring to FIG. 5, thepedicle screw is located at a precise position of the spine by means ofa position indication driver 30.

The position indication driver 30 has a handle 34 and an elongatedneedle 32 extending downward from the handle 34. The elongated needle 32is inserted into the guide hole 19 by passing through the screw hole 17of the recess 14.

The elongated needle 32 downwardly protrudes beyond a lower end of thescrew section 20 of the pedicle screw and makes contact with the spine.When the elongated needle 32 is moved into a precise position of thespine by moving the position indication driver 30, the pedicle screw isalso located in the precise position of the spine. In this state, thepedicle screw is inserted into the spine by rotating the pedicle screw.After that, the position indication driver 30 is separated from thepedicle screw by upwardly pulling the position indication driver 30.

Thus, it is not necessary for the operator to move the pedicle screwwhile enlarging an incision part in order to find a coupling position ofthe pedicle screw with regard the spine because the elongated needle 32can point the coupling position of the pedicle screw. The pedicle screwis rotatably inserted into the spine by means of a separate driver (notshown).

FIG. 6 is a perspective view showing usage of a pedicle screw 1according to one embodiment of the present invention. Referring to FIG.6, the rod 104 is inserted into the pedicle screw 1 from a lateralportion of the pedicle screw 1. In this case, the rod 104 is preventedfirm being separated upwardly from the pedicle screw 1 due to thesupport unit even if the operator does not conduct any additionalprocedures.

When the rod 104 has been inserted into the recess 14 from the lateralportion of the recess 14, the coupling screw 102 is screw-coupled intothe screw hole 17 while pressing the rod 104 downward. Since the rod 104is prevented from upwardly moving from the recess 14, it is necessary topush the rod 104 in the lateral direction when removing the rod 104 fromthe recess 14.

In short, due to the support unit 18, the rod 104 inserted into therecess 14 is prevented from being separated from the recess 104 even ifthe coupling screw 102 has not been screw-coupled with the recess 14, sothe operator can easily perform the surgical operation.

Although it is described that the head section of the pedicle screw isintegrally formed with the screw section, the present invention can beapplicable for a multi-axial pedicle screw in which a head section isseparated from a screw section so that the screw section can move withregard to the head section.

FIG. 7 is a perspective view showing an operating device for a pediclescrew according to one embodiment of the present invention, FIG. 8 is afront view showing the operating device for the pedicle screw, and FIG.9 is a plan view showing the operating device for the pedicle screw.Referring to FIG. 7 to 9, the operating device for the pedicle screwincludes a body 230, a rotating member 210 rotatably coupled to a rearportion of the body 230, at least two screw coupling rods 250 verticallycoupled to a front portion of the body 230, and a rod receiver 220provided at a second end 212 of the rotating member 210 in the form of acurved rod and extends toward a lower end of the screw coupling rods250.

The rotating member 210 preferably has a reverse “L” shape and a firstend of the rotating member 210 is coupled to the rear portion of thebody 230 through a rotary screw shaft 214 such that the rotating member210 can rotate about the rotary screw shaft 214. The second end 212 ofthe rotating member 210 is formed with a hole so as to receive the rodreceiver 220 therein. As the rotating member 210 rotates, the rodreceiver 220 is also moved in up and down directions.

An upper end portion of the rod receiver 220 is coupled with the secondend 212 of the rotating member 210. In addition, the rod 104 isdetachably coupled with a lower end portion of the rod receiver 220. Therod receiver 220 has a curved structure in the form of an arc having apredetermined curvature. As the rotating member 210 rotates, the rodreceiver 220 also rotates along a predetermined circular route.Preferably, the rod 104 inserted into the lower end portion of the rodreceiver 222 has a curved structure with a predetermined curvatureidentical to the curvature of the rod receiver 220. Reference numeral224 represents a fastening screw 224.

The rotating member 210 is connected to the screw coupling rod 250through the body 230. Preferably, the body 230 has a “

”-shaped structure when looking at the body 230 from the upper region ofthe body 230. The body 230 is provided at a middle portion thereof witha central protrusion 232 and one end of the rotary screw shaft 214 isinserted into the central protrusion 232 while interposing the first endof the rotating member 210 therebetween. The body 230 includes anelongated rod 234. The central protrusion 232 is provided at a middleportion of the elongated rod 234. A coupling slot 236 is longitudinallyformed along an upper portion of the coupling screw 234. At least twoscrew coupling rods 250 are vertically coupled to the elongated rod 234in such a manner that the angel of the screw coupling rods 250 can beslightly adjusted.

The screw coupling rod 250 has a hollow pipe shape and an upper end ofthe screw coupling rod 250 is coupled to the elongated rod 234. Apedicle screw (not shown) is inserted into a lower end of the screwcoupling rod 250. The screw coupling rod 250 is formed with a perforatedhole 254. A driver (not shown) may be inserted into the perforated hole254 of the screw coupling rod 250 in order to manipulate the pediclescrew. Preferably, a rod hole 256 is formed at a lower lateral portionof the screw coupling rod 250. The rod hole 256 receives a head sectionof the pedicle screw. That is, as the rotating member 210 rotates, therod 105 inserted into the second end 222 of the rod receiver 220 isintroduced into the head section of the pedicle screw by passing throughthe rod hole 256. Coupling members 240 are provided to couple the screwcoupling rods 250 to the elongated rod 234 of the body 230. Each of thecoupling members 240 has a hexahedral structure and the elongated rod234 of the body 234 passes through the coupling member 240. In addition,a protrusion 258 of the screw coupling rod 250 is inserted into thecoupling member 240. A first screw 242 is screw coupled into thecoupling member 240 in order to fix the elongated rod 234 and a secondscrew 252 is screw coupled into the coupling member 240 in order to fixthe protrusion 258 of the coupling rod 250.

The first screw 242 is inserted into the coupling slot 236 of theelongated rod 234. The first screw 242 extends toward an inner portionof the coupling member 240 by passing through an upper surface of thecoupling member 240 so that an end portion of the first screw 242 isinserted into the coupling slot 236 of the elongated rod 234. Whenreleasing the first screw 242, the coupling member 240 can move alongthe elongated rod 234. In addition, the coupling member 240 can be fixedto predetermined portion of the elongated rod 234 when fastening thefirst screw 234.

The second screw 252 is screw-coupled into the coupling member 240 inorder to adjust a rotational angle or a gradient of the screw couplingrod 250. The protrusion 258 inserted into the coupling member 240 isprovided at an upper end portion of the screw coupling rod 250 and thesecond screw 252 makes contact with the protrusion 258 of the screwcoupling rod 250 by passing through the coupling member 240.

The protrusion 258 has a cylindrical shape and is rotatably insertedinto the coupling member 240. As the protrusion 258 rotates, the screwcoupling rod 250 is slightly moved by a predetermined angle. Thus, aposition of the screw coupling rod 250 is adjusted in a state that thesecond screw 252 is slightly released. Then, the second screw 252 isfastened such that the second screw 252 fixedly presses the protrusion258, so the position of the screw coupling rod 250 is fixed with respectto the body 230.

FIG. 10 is a perspective view showing an operational state of theoperating device for the pedicle screw according to one embodiment ofthe present invention. Referring to FIG. 10, the pedicle screw 1 isinserted into a lower portion of the screw coupling rod 250. In thisstate, the rod 104 is inserted into the pedicle screw 1 by rotating therotating member 210 in the downward direction.

That is, the pedicle screw 1 is coupled with the screw coupling rod 250and the position of the body 230 is determined according to the positionof the screw coupling rod 250. As the rotating member 210 coupled withthe body 230 rotates in the downward direction, the rod receiver 220 andthe rod 104 connected to the second end 212 of the rotating member 210may be directed toward the rod hole 256 formed at the lower end portionof the screw coupling rod 250.

Thus, the operator can easily insert the rod 104 into the pedicle screw1 without performing additional inspection work by simply rotating therotating member 210 in the downward direction thereof. Therefore, if twoincisions for two pedicle screws 1 and one incision for the rod 104 andthe rod receiver 220 are made in the back of the patient, the rod 104can be easily inserted into the pedicle screw 1.

When the rod 104 coupled with a detachment section 222 of the rodreceiver 220 has been placed in the head section of the pedicle screw 1due to the rotation of the rotating member 210, the coupling screw 102(see, FIG. 1) is inserted into the perforated hole of the screw couplingrod 250 and the driver is also inserted into the perforated hole of thescrew coupling rod 250 in order to fasten the coupling screw 102,thereby fixedly securing the rod 104 to the pedicle screw 1. After that,the rod 104 is separated from the rod receiver 220 and the rotatingmember 210 is rotated in the upward direction, thereby removing the rodreceiver 220 from the back of the patient.

FIG. 11 is an enlarged sectional view showing the rod inserted into therod receiver according to one embodiment of the present invention, andFIG. 12 is an enlarged sectional view showing the rod being separatedfrom the rod receiver according to one embodiment of the presentinvention. Referring to FIGS. 11 and 12, the rod 104 is partiallyinserted into the detachment section 222 of the rod receiver 220. Thedetachment section 222 is formed at a lower end portion of the rodreceiver 220 in order to detachably receive the rod 104. The rod 104 isformed at one end thereof with a female screw section 104 a such thatthe rod 104 can be screw-coupled with the rod receiver 220. The femalescrew section 104 a is formed at an inner wall part of a hole formed inthe rod 104. A flexible shaft 226 is positioned in the rod receiver 220.A male screw section 226 a of the flexible shaft 226 is located in thevicinity of the detachment section 222 of the rod receiver 220. The rod104 has a curved shape in the form of an arc and the female screwsection 104 a formed at one end of the rod 104 is screw-coupled with themale screw section 226 a of the flexible shaft 226.

The flexible shaft 226 is made from a synthetic resin material, such asplastic, which can be easily bent without deforming a shape thereof. Anupper portion of the flexible shaft 226 is connected to a fasteningscrew 224 provided at an upper end portion of the rod receiver 220. Asthe fastening screw 224 rotates, the flexible shaft 226 also rotates.

The male screw section 226 a of the flexible shaft 226 may be coupledwith the female screw section 104 a of the rod 104 or released from thefemale screw section 104 a of the rod 104 according to a rotationaldirection of the fastening screw 224. If the flexible screw 226 rotatesin one direction as shown in FIG. 8, the rod 104 is separated from theflexible screw 226. Accordingly, the rod 104 can be easily implantedinto the spine of the patient through the steps of inserting the rod 104into a target position in the pedicle screw 1, separating the rod 104from the flexible screw 226 by rotating the fastening screw 224, andlifting the rotating member 210.

As described above, the pedicle screw according to the present inventionhas a support unit capable of preventing a rod from being easilyseparated from the pedicle screw, thereby facilitating minimum incisionsurgery.

In addition, the pedicle screw according to the present invention isformed with a guide hole, which receives a position indication driver,so the operator can easily detect a precise insertion point of thepedicle screw during minimum incision surgery.

In addition, the present invention provides an operating device for thepedicle screw, capable of implanting a plurality pedicle screws into thebody of the patient while making several incisions for the pediclescrews and the rod in the back of the patient and keeping the size ofincisions quite a small.

Furthermore, the operating device for the pedicle according to thepresent invention may allow an operator to easily insert the rod intothe pedicle screw inserted into the incision made in the patient's backwithout checking the location of the pedicle screw and the rod with thenaked eye.

In addition, the operating device for the pedicle according to thepresent invention can easily separate the rod from the pedicle screwafter the rod has been inserted into the pedicle screw.

The operating device for the pedicle according to the present inventionincludes a screw coupling rod, so the number of pedicle screws used forminimum incision surgery may increase without limitation.

Although a preferred embodiment of the present invention has beendescribed for illustrative purposes, those skilled in the art willappreciate that various modifications, additions and substitutions arepossible, without departing from the scope and spirit of the inventionas disclosed in the accompanying claims.

The present disclosure relates to subject matter contained in KoreanPatent Application Nos. 10-2002-0056911, filed on Jul. 21, 2004, and10-2004-0056912, filed on Jul. 21, 2004, the contents of both are hereinexpressly incorporated by reference in their entireties.

1. A pedicle screw comprising: a head section including a recess partdefined by first and second sidewalls; a screw section; and a supportunit formed at an upper portion of the recess part of the head sectionwhile connecting the first sidewall to the second sidewall.
 2. Thepedicle screw as claimed in claim 1, wherein the pedicle screw has aguide hole extending from an inner bottom surface of the head section toa lower end portion of the screw section.
 3. An operating device for apedicle screw, the op g device comprising: a screw coupling rod havingan elongated pipe shape; a body having a first side coupled to the screwcoupling rod; a rotating member having a first end coupled to a secondside of the body in such a manner that a second end of the rotatingmember rotates about the first end thereof; and a rod receiver coupledto the second end of the rotating member.
 4. The operating device asclaimed in claim 3, wherein the body includes a coupling hole into whichthe first end of the rotating member is inserted and an elongated rodhaving a coupling slot for coupling the screw coupling rod.
 5. Theoperating device as claimed in claim 4, wherein the screw coupling rodis coupled to the body by means of a coupling member, the elongated rodextends by passing through the coupling member, and the coupling memberis provided with a first screw, which is screw-coupled with the couplingslot, and a second screw for supporting the screw coupling rod.
 6. Theoperating device as claimed in claim 3, wherein the rod receiver has acurved shape in the form of an arc.
 7. The operating device as claimedin claim 3, wherein a rod is detachably coupled to one end of the rodreceiver.
 8. The operating device as claimed in claim 3, wherein thescrew coupling rod has an upper end portion coupled to the body and alower end portion into which a pedicle screw is inserted.
 9. Theoperating device as claimed in claim 7, wherein the rod receiver isprovided at an inner portion thereof with a flexible shaft which isscrew-coupled with one end of the rod, and the rod is coupled with orseparated from the rod receiver according to a rotational direction ofthe flexible shaft.
 10. The operating device as claimed in claim 8,wherein the screw coupling rod is formed at a lower end portion thereofwith a rod hole.